Casino Night Registration and Underwriting

Exit this survey

 

*

1. Registration and Underwriting Information for the St. Mary of Carmel Annual Casino Night on April 24th

Registration and Underwriting Information for the St. Mary of Carmel Annual Casino Night on April 24th   Name:
Address:
Address 2:
City/Town:
State:	-- select state --AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

2. I would like to participate in the Texas Hold' Em Tournament, and need the following number of tickets ($100 playing fee per person)

I would like to participate in the Texas Hold' Em Tournament, and need the following number of tickets ($100 playing fee per person)   1 2 3 4 5 6 7 8 9 10

3. I will attend as a non-tournament guest ($40 per person) and would like the following number of tickets.

I will attend as a non-tournament guest ($40 per person) and would like the following number of tickets.   1 2 3 4 5 6 7 8 9 10

4. I am going with a partner and would like to pay the $75 promotional ticket price for two tickets as a non-tournament guest.

I am going with a partner and would like to pay the $75 promotional ticket price for two tickets as a non-tournament guest.   Yes No

5. I cannot attend Casino Night but would like to make a tax-deductible donation to help underwrite the event. (Please see donor levels below)

I cannot attend Casino Night but would like to make a tax-deductible donation to help underwrite the event. (Please see donor levels below)   Platinum Eagle Donor - $1,000 and up Golden Eagle Donor - $500- $999 Silver Eagle Donor - $250-$499 Bronze Eagle Donor - $100-$249

6. Payment for Casino Night may be made by sending a check to: St. Mary of Carmel Catholic School 1716 Singleton Blvd. Dallas, TX 75212. Payment can also be completed the night of the event. Tickets will be available for pick up at the registration table on April 24th. All donations are tax deductible. Please keep a copy for your records.

Payment for Casino Night may be made by sending a check to: St. Mary of Carmel Catholic School 1716 Singleton Blvd. Dallas, TX 75212. Payment can also be completed the night of the event. Tickets will be available for pick up at the registration table on April 24th. All donations are tax deductible. Please keep a copy for your records.   I will send my check in to St. Mary of Carmel Catholic School I wil pay the night of the event at the registration table